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Advance Care Planning: Preparing for Your Future Healthcare

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Are you prepared?

All Albertans should prepare for a possible scenario where they may be unable to make their own medical decisions, especially if they are older or have chronic or serious illness.

If you became seriously ill, would your family, caregivers and healthcare providers know how you would want to be cared for? Who would speak for you if you were too sick to speak for yourself?

Learn more about advance care planning.

Advance Care Planning

A way to help you think about, talk about and document wishes for health care in the event that you become incapable of consenting to or refusing treatment or other care.

You may never need your advance care plan – but if you do, you’ll be glad that it’s there and that you have had these conversations, to make sure that your voice is heard when you cannot speak for yourself.

Goals of Care Designation

A medical order used to describe and communicate the general aim or focus of care including the preferred location of that care.

Although advance care planning conversations don’t always result in determining goal of care designation, they make sure your voice is heard when you cannot speak for yourself

Medical Care icon

Medical Care

Focuses on medical tests and interventions to cure or manage a person’s illness, but does not use resuscitative or life support measures.

Comfort Care

Comfort Care

Focuses on providing comfort for people with life-limiting illness when medical treatment is no longer an option.

Resuscitative Care

Resuscitative Care

Focuses on prolonging or preserving life using medical or surgical interventions, including, if needed, resuscitation and intensive care.

Learn about Goals of Care Designation ordersIf you can’t speak for yourself, your Goals of Care Designation helps the healthcare team match your values and preferences to care that is right for you and your healthcare condition.

Personal directive: Choose your decision-makerYour personal directive is a legal document. It names someone you trust to make important decisions for you if you can’t make these decisions yourself.

Keep advance care planning documents in a Green SleeveThis is a plastic pocket that holds your advance care planning forms.

Resources | video libraryGet more information on advance care planning and find more resources to help you or explore our video library.

 

Red Deer Primary Care Network (RDPCN) is a partnership between Family Doctors and Alberta Health Services. Health professionals such as psychologists, social workers, nurses and pharmacists work in clinics alongside family doctors. In addition, programs and groups are offered at the RDPCN central location. This improves access to care, health promotion, chronic disease management and coordination of care. RDPCN is proud of the patient care offered, the effective programs it has designed and the work it does with partners in health care and the community. www.reddeerpcn.com

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Common Vaccines Linked to 38-50% Increased Risk of Dementia and Alzheimer’s

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By Nicolas Hulscher, MPH

The single largest vaccine–dementia study ever conducted (n=13.3 million) finds risk intensifies with more doses, remains elevated for a full decade, and is strongest after flu and pneumococcal shots.

The single largest and most rigorous study ever conducted on vaccines and dementia — spanning 13.3 million UK adults — has uncovered a deeply troubling pattern: those who received common adult vaccines faced a significantly higher risk of both dementia and Alzheimer’s disease.

The risk intensifies with more dosesremains elevated for a full decade, and is strongest after influenza and pneumococcal vaccination. With each layer of statistical adjustment, the signal doesn’t fade — it becomes sharper, more consistent, and increasingly difficult to explain away.

And critically, these associations persisted even after adjusting for an unusually wide range of potential confounders, including age, sex, socioeconomic status, BMI, smoking, alcohol-related disorders, hypertension, atrial fibrillation, heart failure, coronary artery disease, stroke/TIA, peripheral vascular disease, diabetes, chronic kidney and liver disease, depression, epilepsy, Parkinson’s disease, cancer, traumatic brain injury, hypothyroidism, osteoporosis, and dozens of medications ranging from NSAIDs and opioids to statins, antiplatelets, immunosuppressants, and antidepressants.

Even after controlling for this extensive list, the elevated risks remained strong and remarkably stable.


Vaccinated Adults Had a 38% Higher Risk of Dementia

The primary adjusted model showed that adults receiving common adult vaccines (influenza, pneumococcal, shingles, tetanus, diphtheria, pertussis) had a:

38% increased risk of developing dementia (OR 1.38)

This alone dismantles the narrative of “vaccines protect the brain,” but the deeper findings are far worse.


Alzheimer’s Disease Risk Is Even Higher — 50% Increased Risk

Buried in the supplemental tables is a more shocking result: when the authors restricted analyses to Alzheimer’s disease specifically, the association grew even stronger.

50% increased risk of Alzheimer’s (Adjusted OR 1.50)

This indicates the effect is not random. The association intensifies for the most devastating subtype of dementia.


Clear Dose–Response Pattern: More Vaccines = Higher Risk

The authors ran multiple dose–response models, and every one of them shows the same pattern:

Dementia (all types)

From eTable 2:

  • 1 vaccine dose → Adjusted OR 1.26 (26% higher risk)
  • 2–3 doses → Adjusted OR 1.32 (32% higher risk)
  • 4–7 doses → Adjusted OR 1.42 (42% higher risk)
  • 8–12 doses → Adjusted OR 1.50 (50% higher risk)
  • ≥13 doses → Adjusted OR 1.55 (55% higher risk)

Alzheimer’s Disease (AD) Shows the Same—and Even Stronger—Trend

From eTable 7:

  • 1 dose → Adjusted OR 1.32 (32% higher risk)
  • 2–3 doses → Adjusted OR 1.41 (41% higher risk)
  • ≥4 doses → Adjusted OR 1.61 (61% higher risk)

This is one of the most powerful and unmistakable signals in epidemiology.


Time–Response Curve: Risk Peaks Soon After Vaccination and Remains Elevated for Years

Another signal strongly inconsistent with mere bias: a time-response relationship.

The highest dementia risk occurs 2–4.9 years after vaccination (Adjusted OR 1.56). The risk then slowly attenuates but never returns to baseline, remaining elevated across all time windows.

After 12.5 years, the risk is still meaningfully elevated (Adjusted OR 1.28) — a persistence incompatible with short-term “detection bias” and suggestive of a long-lasting biological impact.

This pattern is what you expect from a biological trigger with long-latency neuroinflammatory or neurodegenerative consequences.


Even After a 10-Year Lag, the Increased Risk Does Not Disappear

When the authors apply a long 10-year lag — meant to eliminate early detection bias — the elevated risk persists:

  • Dementia: OR 1.20
  • Alzheimer’s: OR 1.26

If this were simply “people who see doctors more often get diagnosed earlier,” the association should disappear under long lag correction.


Influenza and Pneumococcal Vaccines Drive the Signal

Two vaccines show particularly strong associations:

Influenza vaccine

  • Dementia: OR 1.39 → 39% higher risk
  • Alzheimer’s: OR 1.49 → 49% higher risk

Pneumococcal vaccine

  • Dementia: OR 1.12 → 12% higher risk
  • Alzheimer’s: OR 1.15 → 15% higher risk

And again, both exhibit dose–response escalation — the hallmark pattern of a genuine exposure–outcome relationship.


Taken together, the findings across primary, supplemental, dose–response, time–response, stratified, and sensitivity analyses paint the same picture:

• A consistent association between cumulative vaccination and increased dementia risk

• A stronger association for Alzheimer’s than for general dementia

• A dose–response effect — more vaccines, higher risk

• A time–response effect — risk peaks after exposure and persists long-term

• Influenza and pneumococcal vaccines strongly drive the signal

• The association remains after 10-year lag correction and active comparator controls

This is what a robust epidemiologic signal looks like.


In the largest single study ever conducted on vaccines and dementia, common adult vaccinations were associated with a 38% higher risk of dementia and a 50% higher risk of Alzheimer’s disease. The risk increases with more doses, persists for a decade, and is strongest for influenza and pneumococcal vaccines.


Nicolas Hulscher, MPH

Epidemiologist and Foundation Administrator, McCullough Foundation

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Pharma Bombshell: President Trump Orders Complete Childhood Vaccine Schedule Review

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Peter A. McCullough, MD, MPH's avatar Peter A. McCullough, MD, MPH

After unnecessary hepatitis B vaccine dropped for 3.6 million annual healthy live births, POTUS calls for entire ACIP schedule to better align with other countries

After the CDC ACIP panel voted 8-3 to drop the hepatitis B vaccine for millions of healthy babies born from seronegative mothers, President Trump who has previously said the ACIP schedule is a “disgrace” has ordered a review of the US vaccine schedule in relationship to the countries. Alter AI assisted in this review.

Based on the 2025 immunization schedules published by health authorities worldwide — including the CDC/ACIP (U.S.)Public Health England/UKHSAHealth CanadaAustralia’s Department of Health, and the EU’s national public health programs — there are significant differences in how intensively children are vaccinated from birth to age 18.

Although all developed countries recommend broadly similar vaccines (targeting diphtheria, measles, polio, etc.), the United States stands at the top in total injections and doses, followed by Canada, France/Germany, the UK, Australia, Sweden, and Japan.


🇺🇸 United States — Approx. 30–32 vaccine doses (counts combination products as single dose) before age 18

The 2025 CDC/ACIP schedule (see CDC PDF schedule, 2025) remains the most aggressive among Western nations.

By age one, a typical American baby receives 20+ doses spanning nine diseases (Hepatitis B, Rotavirus, DTaP, Hib, Pneumococcal, Polio, COVID‑19, Influenza, RSV). By age two, 32 individual antigens including monoclonal antibodies have been received in utero and after birth.

By age six, most children have accumulated around 27 to 29 doses, and around 30–32 total doses by age 18 (including HPV, meningococcal, Tdap boosters, annual flu shots, and now COVID boosters). Doses include combination products, so the number of antigens is much greater approximately 72-93 depending on maternal injections and other factors.

The U.S. uniquely begins vaccination at birth with Hepatitis B (now restricted to ~25,000 seropositive/carrier mothers) and adds multiple annual vaccines regardless of local exposure risk. It also promotes simultaneous injection of up to six vaccines at once (“combination vaccines” or same-visit stacking), magnifying early childhood exposure to adjuvants and preservatives.


🇨🇦 Canada — ≈ 25–28 doses

Canada’s national and provincial schedules (see Health Canada) mirror the U.S., but some provinces delay or skip optional vaccines (like flu or COVID‑19 for healthy children). Fewer boosters are required for diphtheria-tetanus-pertussis after age seven, and not all provinces include HPV for boys.
Canada therefore averages 2–4 fewer total doses than the United States.


🇫🇷 France / 🇩🇪 Germany — ≈ 22–25 doses

European Union countries vary widely:

  • France mandates 11 childhood vaccines (including Hep B and Hib), but does not recommend early COVID‑19 or influenza vaccination for all children.
  • Germany (STIKO guidelines) offers a schedule very similar to the U.S. through age 2 but limits repeated influenza and COVID vaccination to high-risk groups, capping childhood totals around 22–24 doses.

European nations also tend to delay vaccination start ages to 8–12 weeks instead of giving Hep B or other shots at birth, resulting in fewer injections during infancy and more gradual immune stimulation.


🇬🇧 United Kingdom — ≈ 20–21 doses

The UK’s NHS and UKHSA recommend a smaller, slower schedule than North America’s. Infants receive about 16–18 doses by age 5, increasing to 20–21 by age 18.
Notably:

  • The UK still does not include chickenpox (varicella) as a routine childhood vaccine (unlike the U.S.).
  • No routine flu or COVID vaccination for healthy children under school age.
  • Uses combined 6‑in‑1 (DTaP/Hep B/Polio/Hib) and MMR vaccines, minimizing injections.

🇦🇺 Australia — ≈ 20 doses

Australia’s National Immunisation Program (NIP) mirrors the UK more closely than the U.S.
Infants start at 6–8 weeks, not at birth (Hep B exception). Only one influenza vaccine per year is recommended, and chickenpox is given later. No universal COVID vaccine for healthy under‑5s.
Total injections: about 20 by adulthood.


🇸🇪 Sweden / 🇳🇴 Norway — ≈ 16–18 doses

Nordic countries follow some of the world’s most minimalist Western schedules:

  • No routine chickenpox, no birth shots, no annual flu or COVID for healthy kids.
  • Combined vaccines reduce needle count.
  • Emphasis on fewer but spaced doses (e.g., 3‑dose DTaP schedule instead of 5).

Children typically receive around 16–18 total injections before 18 — roughly half the U.S. burden — without suffering higher rates of “vaccine‑preventable” illness, challenging the dogma that more vaccines equal better outcomes.


🇯🇵 Japan — ≈ 14–16 doses

Historically the most cautious industrialized nation, Japan delayed and later reduced its vaccine schedule after serious adverse events in the 1990s.
Although it now recommends many standard vaccines, lower frequency, single-antigen use, and minimal early‑life stacking mean the total doses remain lowest in the developed world, around 14–16 through adolescence.
Japan’s infant mortality and autism rates are lower than in the U.S., prompting renewed scientific interest in whether slower schedules might lower iatrogenic risk.


📊 Summary — Total Vaccine Doses (Ages 0–18 Years)

Rank Country Approx. cumulative doses Notes on schedule intensity 1 🇺🇸 United States 30–32 Most intensive; starts at birth; annual flu + COVID 2 🇨🇦 Canada 25–28 Slightly milder than U.S.; fewer mandatory boosters 3 🇫🇷 France / 🇩🇪 Germany 22–25 Similar core vaccines; delayed start; selective flu use 4 🇬🇧 United Kingdom 20–21 No varicella or universal flu/COVID; efficient combinations 5 🇦🇺 Australia ≈ 20 Spaced schedule; limited COVID coverage 6 🇸🇪 Sweden / 🇳🇴 Norway 16–18 Simplified; no birth or seasonal routine vaccines 7 🇯🇵 Japan 14–16 Most delayed; minimal birth and combination doses


💡 Interpretation

The data show a clear gradient: the United States vaccinates children more frequently and at earlier ages than any other Western nation, often stacking combinations before immune maturity. Nations with slower, smaller schedules — Sweden and Japan most notably — maintain equal or superior child health metrics, casting doubt on the premise that maximal dosing guarantees better outcomes.

The U.S. model prioritizes population‑wide compliance and theoretical herd immunity, while Europe and Japan incorporate a more individualized risk‑based approach. Given the expanding scientific literature on rising childhood allergic and neuropsychiatric illnesses, these cross‑national differences underscore the need for independent, transparent studies comparing long‑term health outcomes by cumulative vaccine burden — something major regulatory agencies have conspicuously avoided.

FOCAL POINTS (Courageous Discourse) is a reader-supported publication.

To receive new posts and support my work, consider becoming a free or paid subscriber.

Please subscribe to FOCAL POINTS as a paying ($5 monthly) or founder member so we can continue to bring you the truth.

Peter A. McCullough, MD, MPH

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